Health incorporated

Organic, natural health-care is under attack. If the current trend continues, say Helen Fullerton and Martin Walker, the world’s health may soon be entirely in the pockets of the mighty pharmaceutical corporations. These are the opening lines to an article published in March 2000, but still a very interesting read.

We now are in the midst of an all-out concerted attack on natural remedies, supplements, non conventional cures - anything that could compete with the pharmaceutical paradigm in medicine. That outdated paradigm is dear to the hearts of both investors in pharmaceutical fortunes and those in government who are supposed to promote public health but have ended up promoting pharmaceutical profits instead.

How did we get into the current pickle? The article by Helen Fullerton and Martin Walker brings us up to speed on the events of the last two decades leading up to the current confrontation.

Organic, natural health-care is under attack. If the current trend continues, say Helen Fullerton and Martin Walker, the world’s health may soon be entirely in the pockets of the mighty pharmaceutical corporations.

Health and its maintenance, in contemporary ‘developed’ society, is complex. Perhaps the most important part of this complexity, however, is the ongoing conflict between individual health-care and the professional, pharmacological response to disease which has come to dominate society.

General levels of health in developed societies have steadily improved over the last hundred years, broadly because of developments in the life sciences and public health. This progress, however, seems to bear little relationship to the delivery of medicine. While scientific medicine has generated some solutions, it has also bequeathed deadly problems. Crucially, it has led to a virtual takeover of ‘healthcare’ by pharmaceutical corporations and an acceptance that pharmaceutical medicine is primary and best. Yet the extent of the damage done by drugs is enormous. In the US in 1994, it was estimated that there were over two million severe adverse drug reactions, of which 106,000 were fatal(1). Similar calculations suggest that in England, adverse drug reactions are the third most common cause of death(2).

Drug companies have always supported ‘orthodox’ medicine. Medicine’s high-ranking professional bodies were themselves set up with help from pharmaceutical companies, and still receive grants for running costs, hospitality, building and printing. The Royal College of GPs, for example, received Ã‚Â£105,000 from Glaxo, Wellcome and Beecham when it was set up in the early 1950s. The Royal College of Physicians has received funding from the pharmaceutical industry, as has the Royal Society of Medicine. Given this funding, is it surprising that reports sponsored by such bodies so often lambast the use of vitamins, food supplements, nutritional and alternative medicine?

Today, however, the corporatisation of medicine is gaining speed and reaches far beyond the professional institutions of medicine.

THE MEDICAL RESEARCH COUNCIL

The Medical Research Council (MRC), a public body, is the closest thing to a national research institute in Britain. Originally independent, funded entirely by government and concerned with public health, it has veered wildly away from its original purpose. Today, while most of its Ã‚Â£282 million a year funding is public money from the Department of Trade and Industry, the direction of its research is strongly influenced by commercial interests. From 1997 to 1998, eight of the 16-person MRC Council declared vested interests, four of them in the largest pharmaceutical and chemical companies. The MRC’s 1996 Annual Report stated that 96 industrial consultancies are held by MRC staff, and that the MRC itself holds equity in five life-science companies.

MRC earnings from collaboration with industry in 1995 and 1996 were Ã‚Â£6.2 million. A considerable part of the MRC’s work involves carrying out lucrative pharmaceutical trials for the big drug companies. For example, the ‘ISIS-4’ trial conducted by the Clinical Trials Unit at Oxford, supported by the MRC and the British Heart Foundation (BHF), compared the effect of tradi-tionally used magnesium in heart attack patients with that of Capitrol, a drug produced by Bristol Myers Squibb (BMS). The results of ISIS-4 suggested that magnesium was ineffective compared with Capitrol. As a consequence of this study, NHS policy shifted away from the use of the cheap and effective magnesium and towards expensive pharmaceutical drugs.

This new clinical policy was accepted despite the fact that it was BMS which paid $6 million for the study and the trial came under considerable critical review because of its methods; especially the use of high doses of magnesium. While collaborative projects with big drug and chemical companies earn money for the MRC, they also help the drug companies make huge profits when drugs given the MRC stamp of approval are sold to the NHS.

THE MOVMEMENT FOR REAL DOCTORS

In the mid-1980s, national campaigns against ‘health fraud’ were set up in the US, Canada and Britain. Although these organisations maintained that they were principally concerned with the delivery of ‘effective health-care’, in fact they constituted aggressive campaigns against the use in health-care of vitamins and food supplements, and against ‘alternative’ health therapies and their practitioners. In Britain, the Campaign Against Health Fraud (HealthWatch) was set up in 1987. Financed initially by medical insurance and pharmaceutical companies, HealthWatch waged an aggressive and very public campaign against alternative, complementary and natural medicines.

A number of its original members were associated with the Wellcome Foundation drug company and its charitable arm the Wellcome Trust. The inauguration of the campaign in the US and Canada, as well as in Britain, began with the licensing and testing of Wellcome’s anti-AIDS drug AZT. The marketing of AZT set a new gold standard for aggressive, covert drug marketing strategies. Every possible influence was used to sell AZT, nationally and internationally both to governments and direct to consumers. Five out of the 25 members of the Medicines Commission which eventually licensed AZT in Britain had connections with Wellcome.

Following the licensing, Wellcome placed money and representatives wherever they could sway opinions. A year after the drug had been licensed, Wellcome gave Ã‚Â£10,000 to the UK’s All-Party Parliamentary Group on AIDS, the gatekeeper for information on AIDS treatments in the House of Commons. Representatives of Wellcome’s PR firms were placed on committees which allocated AIDS funding; the funding went only to groups that were uncritical of AZT. In a move deliberately intended to promote AZT among GPs, Wellcome granted Ã‚Â£144,000 to an AIDS foundation set up by the British Medical Association (BMA). Between 1987 and 1993, when the ‘Concorde’ trials helped hammer several nails into AZT’s coffin by demonstrating that it actually worsened the health of asymptomatic individuals who had tested HIV positive, the drug earned over Ã‚Â£200million for Wellcome.

Contrast this with the case of germanium. In 1988, a highly-qualified bio-science researcher, Dr Sandra Goodman, compiled a literature review of organic germanium. Discovering that researchers from the 1920s onwards had investigated its anti-viral properties, and believing that the substance might help people who tested HIV positive, Dr Goodman pressed the MRC to carry out trials. Despite sending papers to all the relevant committees, meeting with scientists, doctors and politicians, Goodman got nowhere.

Soon after Goodman began to press for the testing of germanium, items began to appear in the media about its dangers to health. The hardest-hitting article(3) carried quotes from Professor Vincent Marks, a founding member of HealthWatch. Marks’ department at Surrey University was in receipt of half a million pounds’ funding from the Wellcome Foundation, some for HIV-related work. Marks called germanium ‘a worthless and dangerous poison’, and said that ‘they [germanium, cadmium and other natural drugs] were killing people by the thousands from kidney failure’. Not long after this article appeared, germanium was banned from sale by the UK Department of Health.

Dr Goodman wrote to the Japanese researchers whom Marks had quoted as reporting kidney damage due to germanium. She found that these researchers had been referring to germanium sesquioxide, a mineral form of germanium. In their return letter, the scientists told her that in recent research they had found organic germanium to be completely non-toxic.

SUPPLEMENT WARS

Pharmaceutical interests have battled fiercely for the last 20 years to restrict the public’s use of vitamin and mineral supplements which pose a threat to their patented, chemical stranglehold on the medicines market. As with the ‘Health Fraud’ episodes, they have employed various strategies. They have claimed that vitamins and food supplements are hazardous to health; that there is no nutritional need for them; and that the public has to be protected against ‘quacks’ who peddle them. In their battle against natural remedies, corporations have succeeded in enshrining in law the principle that nutritional supplements cannot be associated with claims for better health. Finally they have tried to squeeze supplements out of the market by harmonising international trade regulations.

Controlling regulations is the key to killing off natural medicines, and the battle to rationalise them continues. In the UK, a government working group on Dietary Supplements and Health Foods, set up in response to ‘concern about the potential hazards of dietary supplements’(4), produced a highly flawed report which was later used by the EU Commission to prepare a 1992 draft Directive on dietary supplements.

The EU draft Directive ruled that dietary supplements should only be available on the basis of ‘nutritional need’. In Britain, outraged nutritional therapists, organised by Linda Lazarides of the Society for the Promotion of Nutritional Therapies warned that dietary supplements could be swept off the shelves entirely. An unprecedented public campaign to stop the Directive so shook the Council of Ministers that they decided to restrict community legislation ‘to what was strictly needed, and apply where necessary the principle of mutual recognition’. In March 1993, the Commission announced that there was no need for Community Legislation on dietary supplements(5). During the late 1980s, and throughout the 1990s, there were continuous and well-publicised attacks on vitamins and food supplements. In July 1996, acting on the advice of two of its advisory committees, the UK government announced its intention to restrict the free availability of Vitamin B6 to 10mg. The advisers had said that higher levels of B6 could lead to sensory neuropathy (tingling and numbness in the extremities, and disorientation). The 10mg figure was based on an incorrect toxicological extrapolation from animal experimentation, and a biased citation of one study rejected as fraud by all nutritional scientists(6). In April 1998 the US National Academy of Sciences reviewed B6, and reported ‘no observed adverse effect level’, even after prolonged intake of 300mg per day(7). Levels of 25-200mg per day are commonly taken by those deficient in functional B6. In July 1998, the government gave in to protests, and the legislation was reluctantly deferred ‘until a new expert group on vitamins and minerals had reported’.

PLAYING WITH WORDS

The next trick was the best. The pharmaceutical industry and its allies came up with what they thought was a surefire way of banishing natural remedies from the shelves by reclassifying them as medicines. While classified as ‘food supplements’, they could be sold relatively freely, but as ‘medicines’, they would need a product licence – ‘market authorisation’ in Eurospeak. Such a licence could only be obtained on proof not only of ‘safety and quality’, but of ‘efficacy’, a qualification usually ‘proved’ by animal experimentation, and expensive clinical trials.

Unchecked, this strategy would have meant the end of natural remedies. Apart from trial costs, a licence itself would cost upwards of Ã‚Â£80,000 a product. Reclassifying supplements as medicines was the policy of the US Food and Drugs Administration (FDA) in the 1980s. FDA officers – often with guns – would raid clinics looking for ‘illegal’ Vitamin B(8). But an outraged public, almost 50 per cent of whom took supplements, forced a change in the law. In 1994 Congress passed The Dietary Supplement Health and Education Act, which guaranteed free availability of supplements and information as to their function. In Canada, at this time, doctors were struck off simply for prescribing vitamins. Manufacturers were charged exorbitant Drug Identification Number (DIN) fees when they made low-key health claims for products like fish oil. The government’s regulatory body reclassified 167 remedies, including feverfew and ginger, as ‘medicines’(9). As in the US, though, angry citizens raised an outcry, forcing the Health Minister to scrap the DIN fees and declassify food supplements.

The most devastating weapon in the hands of the pharmaceutical industry in Europe has been Article 1 of the 65/65 EU Directive of 1965, which defined a product as a ‘medicine’ if it was used ‘to treat or prevent a disease ... or if it makes medical diagnosis, or ... restores, corrects or modifies a physiological function in human beings ... or in animals’. On these criteria, every food supplement is medicinal, even if no claims are made for it. In 1994, the UK government implemented the Directive using two statutory instruments which were passed without debate.

It was only with the publication of the MCA guidelines (MAL8) that implications were spelt out and massive public protest forced the MCA to back down. In 1998, following the government climbdown over B6 the UK Medicine Control Agency sprung a consultation letter on the health food industry, laying out new procedures whereby the MCA would have sole authority to decide whether a product was a medicine. The document gave the health food industry just one month to respond. The changes were to be brought in on April 1st 1999. Under the proposed regulations, the MCA was to have powers to enter premises with the police, remove ‘illegal’ natural products, and prosecute anyone selling them.

Yet again, however, public protests forced the government to compromise and give reassurances that, ‘the proposals would not change the status of products which are correctly classified now as nutritional supplements and the exemptions for herbal remedies would similarly remain intact’(10). But what was meant by the term ‘correctly classified’?

HARM-ONY?

The international ‘harmonisation’ of medicines is a major part of the strategy to squeeze out non-corporate health-care solutions. The main international instrument of market-fixing is the ‘Codex Alimentarius’, which is empowered by the World Health Organisation (WHO) to set international standards for drugs, food, pesticides and dietary supplements; ‘to guide the world’s growing food industry and to protect the health of consumers’. Codex has a membership of 146 countries, each of which has one vote. Various organisations are allowed to attend meetings, but over 90 per cent of these are multinational corporations. Following lobbying from the multinationals, no state can set higher standards for its own health, environmental protection or consumer freedom than those set by Codex. Any nation setting its own standards could be heavily fined by the WTO. In 1996, Codex met in Bonn to formulate radical changes in the rules that govern dietary supplements. The German delegation had drafted a proposal sponsored by the drug company Hoechst, Bayer and BASF arguing that no herb, vitamin or mineral should be sold for prophylactic or therapeutic reasons and that supplements should be reclassified as drugs. They wanted these regulations to be binding throughout the WTO. The proposals were provisionally accepted on a vote of 16 to two, but later complaints and protests halted their implementation.

THE END OF HEALTH FOODS?

Throughout the 1990s, drug companies forced to accept that supplements and herbs were not going to be simply swept out of the market embarked upon two new stratagems. First, they took over small firms, so that they could incorporate the natural remedies into their pharmaceutical product marketing. Second, many companies merged with the food manufacturers who were incorporating vitamins and minerals into processed foods. If food supplements were put into foods, this would head off the demand for their separate, clinical use and leave the market clear for drugs.

A good example of a vitamin and supplement company ‘changing sides’ is that of Solgar. In 1999, the company was bought by American Home Products, one of the world’s biggest pharmaceutical companies. This means that a previously independent provider of high-quality supplements has now become part of the vicious circle which affects contemporary health in Europe and America. While one arm of a multinational produces health-eroding chemicals, another arm holds out pharmaceuticals and food supplements to help ameliorate the damage.

The most lucrative expansion of pharmaceutical companies, however, is into fortified and functional foods – known as ‘neutraceuticals’. Neutraceutical foods claim health benefits by virtue of their added vitamin, mineral or herbal constituents. These products are advertised as containing anthocyanins as antioxidants, phytoestrogens to protect the heart, and sterols to block cholesterol uptake. In this way, high-sugar low-nutritional junk foods are dressed up as healthy.

It is ironic that the ‘health claims’ issue fought out over the last half-century, against small supplement companies, could finally be settled by multinational food companies, using the rationale of free trade to swamp the EU markets with fortified and functional foods. It would be typical of the ongoing trend towards the corporatisation of human health-care.

THE LOCAL ALTERNATIVE

The most progressive practitioners and researchers in the NHS are presently trying to rationalise health-care, by looking in detail at the effectivity of treatments. The motivation for this rationalisation is, however, the serious fiscal crisis in the health care system. While this approach will undoubtedly lead to the end of unnecessary or unevidenced procedures and a regularisation of best clinical practice, such an approach does not begin to tackle the influence of corporate capitalism in health care. The institutions of medical practice in Britain have fought an unrelenting battle against alternative practitioners of all kinds. Instead of joining forces with the best of these traditions, orthodox medical practitioners have either ignored them or denounced their practitioners as quacks. Meanwhile the real enemy of the people and their health care, industrial science and its vested interests, has crept up and then overtaken the healing physician. If health and healing are to be returned to the community, they have to be decorporatised, and we have to begin again from the base of the community, building health centres in which the local population can participate and where prevention is the first principle. In a post-industrial age our everyday lives are radically affected by multinational companies and our health affected by their products. If we desire autonomy and control over our own bodies, we have to a great extent to resist multinational organisations and the governments which front for them.

Martin J Walker is the author of six books. He is a writer, investigator and lecturer, who, since the publication of his last book, 'Dirty Medicine', has been writing mainly about the social history of environmental health. At the present time, he is researching organophosphate pesticides, factory farming and the history of alternative cancer therapies in Britain.
Helen Fullerton is an independent researcher mainly in trace element and vitamin nutrition, and their contribution to immune responses in humans and animals particularly with respect to current problems such as BSE, bovine TB, chronic organophosphate poisoning, and multiple chemical sensitivity. She has been a lecturer in agricultural chemistry, at Glasgow University, and learned homeopathy when livestock farming.

My comment: Much has happened since this article was written, but as far as it goes, it's an excellent description of how we came to the present situation where more and more of our natural alternatives are legislated away as "dangerous" or "unscientific" - just another way of saying they could be bad for pharma profits.

It might be worth to see other articles on this site, in particular those you find under the headings of

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